The HIV/AIDS epidemic has significantly and dramatically underscored the threat of STDs to the human population. Until there is a cure, or at least an effective treatment, the best, and perhaps only realistic, approach to this increasing problem of STDs (especially HIV/AIDS) appears to be reducing the risk of transmission of STDs by the causative pathogens and thus reducing the number of new infections. Even when STD treatments or cures become available, prevention will likely remain as the first line of defense for economic and medical reasons.
At present, education in regard to STDs, their modes of transmission, and so-called “safe-sex” techniques has, at least to some degree in the more developed countries, shown promise in reducing the risks of STD transmission through sexual activity. Screening of the blood supply has helped to reduce the risk of transmission of such STD-causing organisms via blood transfusions and related medical practices. Nonetheless, the spread of such STDs has not been halted to a satisfactory degree even in developed countries with active and progressive education programs. Even with their known effectiveness in preventing STDs, current safe-sex techniques are not always used, or are not always used properly, for many reasons (e.g., carelessness, lack of knowledge, improper techniques, cultural barriers, unplanned or spontaneous sexual activity, and the like). Moreover, even when used correctly, safe-sex techniques are not always effective. Various birth control devices—including barrier methods and vaginal contraceptives—are currently available. Some of these may, in addition, also have a least some degree of anti-STD activity.
Sexually transmitted diseases, especially HIV/AIDS, also present risks to health care providers and laboratory personnel working with STD-infected patients and/or blood and tissue samples from such patients. Physical contact with the bodily fluids of infected patients can, especially if there are breaks or cuts in the skin, increase the risk of transmission of the STD-causing organisms. In recent years, such health care providers and laboratory personnel have increasingly donned protective clothing and equipment when working with patients or biological samples where exposure to bodily fluids is possible. Latex gloves (often double or triple layered), goggles, protective clothing, and the like are often used when treating or examining patients in both medical and dental offices or working with biological samples from patients (e.g., blood, tissue, and the like). In spite of these precautions, exposure to bodily fluids can still occur. For example, sudden movement by a patient while having a blood sample withdrawn can cause blood to splatter and, perhaps, come in contact with an unprotected part of the body of other persons in the area; needle punctures or scalpel cuts can expose health-care providers to bodily fluids in spite of gloves and other protective layers; or aerosols containing blood and/or saliva can be generated during dental procedures which may contact the body of other persons. Although contact with unbroken and healthy skin is unlikely to result in transmission of the STD, breaks, cuts, or damage to the protective skin layer can increase the risk of transmission.
Treatments are available for many STDs subsequent to infection, but such infections are increasingly showing resistance to available treatments. For example, HIV can become drug resistant to convention antiretroviral therapies. This phenomenon is well established and is monitored by the WHO in developing countries. In the Unites States, 50% of HIV patients receiving treatment are known to be infected with a strain of HIV that expresses resistance to at least one known treatment drug. In one study, nearly 30% of new HIV infections in one region of Africa were of a drug-resistant strain. The particular drug had been introduced only 18 months earlier. Patients with HIV must be monitored for such drug resistance and are typically on a cocktail of drugs to maintain suppression of the infection. Not only can a sexually active person become infected with an already drug resistant strain, but once infected and under treatment, HIV can mutate and thus become resistant to further treatment.
Accordingly, what is needed are improved compounds, compositions, and methods for reducing the risk of STD infections. It would be desirable if such compounds, compositions, and methods would not interfere with the natural and protective vaginal mechanisms so as to maintain the naturally protective vaginal flora and maintain integrity of vaginal and cervical tissues, yet prevent pathogens from infecting host cells such as macrophages and CD4+ cells. It would also be desirable if such compounds, compositions, and methods would be relatively easy to use and have significantly fewer side effects than currently available products so that it would more likely be used on a consistent basis. It would also be desirable if such compounds, compositions, and methods could be used in heterosexual, homosexual, and bisexual relationships and for a wide range of sexual activities. It would also be desirable if such compounds, compositions, and methods could be implemented by either party to the sexual activity. It would also be desirable to provide compounds, compositions, and methods by which the risk of infection by sexually transmitted diseases, especially HIV/AIDS, could be reduced for individuals working with patients and/or biological samples.